Polygenic risk scores point toward potential genetic mechanisms of type 2 myocardial infarction in people with HIV

Won Jun Lee, Haoxiang Cheng, Bridget M. Whitney, Robin M. Nance, Sierra R. Britton, Kristina Jordahl, Sara Lindstrom, Stephanie A. Ruderman, Mari M. Kitahata, Michael S. Saag, Amanda L. Willig, Greer Burkholder, Joseph J. Eron, Jason C. Kovacic, Johan L.M. Björkegren, W. Christopher Mathews, Edward Cachay, Matthew J. Feinstein, Mathew Budoff, Peter W. HuntRichard D. Moore, Jeanne Keruly, Mary E. McCaul, Geetanjali Chander, Allison Webel, Kenneth H. Mayer, Joseph A. Delaney, Paul K. Crane, Claudia Martinez, Heidi M. Crane, Ke Hao, Inga Peter

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: People with human immunodeficiency virus (HIV) infection (PWH) are at higher risk of myocardial infarction (MI) than those without HIV. About half of MIs in PWH are type 2 (T2MI), resulting from mismatch between myocardial oxygen supply and demand, in contrast to type 1 MI (T1MI), which is due to primary plaque rupture or coronary thrombosis. Despite worse survival and rising incidence in the general population, evidence-based treatment recommendations for T2MI are lacking. We used polygenic risk scores (PRS) to explore genetic mechanisms of T2MI compared to T1MI in PWH. Methods: We derived 115 PRS for MI-related traits in 9541 PWH enrolled in the Centers for AIDS Research Network of Integrated Clinical Systems cohort with adjudicated T1MI and T2MI. We applied multivariate logistic regression analyses to determine the association with T1MI and T2MI. Based on initial findings, we performed gene set enrichment analysis of the top variants composing PRS associated with T2MI. Results: We found that T1MI was strongly associated with PRS for cardiovascular disease, lipid profiles, and metabolic traits. In contrast, PRS for alcohol dependence and cholecystitis, significantly enriched in energy metabolism pathways, were predictive of T2MI risk. The association remained after the adjustment for actual alcohol consumption. Conclusions: We demonstrate distinct genetic traits associated with T1MI and T2MI among PWH further highlighting their etiological differences and supporting the role of energy regulation in T2MI pathogenesis.

Original languageEnglish
Pages (from-to)15-23
Number of pages9
JournalInternational Journal of Cardiology
Publication statusPublished - 15 Jul 2023
Externally publishedYes


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